Here in Italy we have a good doctor, Dr. Melcangi, who is investigating the post-finasteride syndrome with interesting results regarding neurosteroid levels in the brain (and in some patients with severe ED, neuropathy of the pudendal nerve):

The sexual symptoms of post-finasteride syndrome are really similar to those of pssd. Perhaps the two syndromes may have a similar etiology, even if triggered by drugs with different action.

Highly probable, soon Melcangi will begin an experimental study on mice to analyze neurosteroid levels in the brain after intake of SSRI. This study will not include the observation of the sexual behavior of the mice (and thus the identification of the topics affected by PSSD).If someone has funds to donate, the study may be more important.

I will link you two texts for those who want to deepen the knowledge of neurosteroids.

a curiosity (perhaps not relevant): Under the names brexanolone and SAGE-547, allopregnanolone is under development by SAGE Therapeutics as an intravenously administered drug. It is in the process of being approved.

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Short term adminstration of SSRIs increase neurosteroid levels. However long term they have the same effect as Finasteride i.e they lower neurosteroid levels. There have already been studies done on this, albeit on mice.

Prevention of the stress-induced increase in the concentration of neuroactive steroids in rat brain by long-term administration of mirtazapine but not of fluoxetine

In contrast, long-term administration (10 mg/kg i.p., once daily for 2 weeks) of fluoxetine, but not that of mirtazapine, induced marked decreases in the cortical and plasma concentrations of these neuroactive steroids.

Opposite effects of short- versus long-term administration of fluoxetine on the concentrations of neuroactive steroids in rat plasma and brain

A single dose of fluoxetine (20 mg/kg, i.p.) induced in 20 min significant increases in the cerebral cortical and plasma concentrations of 3alpha,5alpha-TH PROG (+96% and +13%, respectively), 3alpha,5alpha-TH DOC (+129 and +31%, respectively), progesterone (+111 and +58%, respectively), and pregnenolone (+151 and +59%, respectively). In addition, the plasma concentration of corticosterone was also significantly increased (+24%) after acute administration of fluoxetine. In contrast, long-term administration of fluoxetine reduced the basal concentrations of these various steroids (ranging from -22 to -43%), measured 48 h after the last drug injection, in both brain and plasma.

nasibi wrote:Short term adminstration of SSRIs increase neurosteroid levels. However long term they have the same effect as Finasteride i.e they lower neurosteroid levels. There have already been studies done on this, albeit on mice.

Prevention of the stress-induced increase in the concentration of neuroactive steroids in rat brain by long-term administration of mirtazapine but not of fluoxetine

In contrast, long-term administration (10 mg/kg i.p., once daily for 2 weeks) of fluoxetine, but not that of mirtazapine, induced marked decreases in the cortical and plasma concentrations of these neuroactive steroids.

Opposite effects of short- versus long-term administration of fluoxetine on the concentrations of neuroactive steroids in rat plasma and brain

A single dose of fluoxetine (20 mg/kg, i.p.) induced in 20 min significant increases in the cerebral cortical and plasma concentrations of 3alpha,5alpha-TH PROG (+96% and +13%, respectively), 3alpha,5alpha-TH DOC (+129 and +31%, respectively), progesterone (+111 and +58%, respectively), and pregnenolone (+151 and +59%, respectively). In addition, the plasma concentration of corticosterone was also significantly increased (+24%) after acute administration of fluoxetine. In contrast, long-term administration of fluoxetine reduced the basal concentrations of these various steroids (ranging from -22 to -43%), measured 48 h after the last drug injection, in both brain and plasma.

I will try low dose Fluoxetine for two reasons:a) it was the SSRI I was on.b) because of the articles Jaxx posted on p 23 in the low dose SSRI thread, where they make the connection between low dosing SSRI (Fluoxetine in their case) and neurosteroids, namely allopregnanolone.

But before i start this trial, I will supplement Progesterone (found out that my level is practically non-existent) and Estradiol, which is also very low and see how this goes before I start adding low dosing Prozac.